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Guillain-Barre Syndrome: Symptoms, Causes and Treatments
Written by Medicover Team and Medically Reviewed by Dr Shrikant Deshmukh , Neurologist
Guillain-Barre Syndrome (GBS) is a rare but serious neurological disorder where the body’s immune system mistakenly attacks the nerves. This can lead to symptoms such as tingling, muscle weakness, and even temporary paralysis. The condition often begins in the legs or arms and can spread quickly, sometimes affecting breathing and heart function in severe cases.
While GBS can affect people of any age, it often starts after a recent infection, such as a cold, the flu, gastrointestinal illness, or viral illnesses like COVID-19 or Zika. These infections are sometimes linked to what's commonly called the GBS virus, although GBS itself isn’t a virus. It’s the body’s immune reaction to the infection that causes the problem. Because the condition can worsen quickly, early diagnosis and medical attention are very important.
Early medical care is essential. With treatments like immunotherapy and physical therapy, most people make a good recovery, although it can take weeks or months to regain strength fully.
What is Guillain-Barre Syndrome (GBS)?
Guillain-Barre Syndrome (GBS) is an autoimmune disorder in which the immune system attacks the peripheral nervous system, the network of nerves outside the brain and spinal cord. These nerves help control your muscle movements and allow you to feel sensations like touch, temperature, and pain.
When these nerves are damaged, communication between the brain and muscles is disrupted. This leads to symptoms such as:
- Numbness and tingling (usually starting in the feet or hands)
- Muscle weakness
- Loss of reflexes
- In severe cases, difficulty walking, breathing, or swallowing
The exact cause of GBS isn’t fully understood, but it often follows a viral or bacterial infection. In these cases, the immune system, while fighting off the infection, accidentally begins to attack healthy nerves.
GBS is considered a medical emergency, as symptoms can worsen quickly. Most people need to be treated in a hospital. While there’s no specific cure, treatments like plasmapheresis (plasma exchange) or IV immunoglobulin (IVIG) can help reduce the immune system's attack and speed up recovery.
What are the Guillain-Barre Syndrome Symptoms?
Guillain-Barre Syndrome (GBS) is a neurological condition that can develop suddenly and worsen quickly. The symptoms of Guillain-Barre Syndrome are caused by the immune system attacking the peripheral nerves, which control muscle movement and how you feel sensations like touch, temperature, and pain.
The first signs of GBS often include tingling, numbness, or a “pins and needles” feeling in the feet and hands. These symptoms may seem mild at first, but can progress rapidly over hours or days. The condition usually affects both sides of the body and may start in the legs before spreading upward to the arms, face, and even the chest. Early recognition of symptoms can make a critical difference in treatment and recovery.
Here are some of the most common Guillain-Barre disease symptoms to watch for:
- Tingling or numbness in the feet, legs, hands, or arms
- Muscle weakness, usually starting in the legs and moving upward
- Difficulty walking, climbing stairs, or standing for long periods
- Loss of coordination or unsteady movements
- Facial muscle weakness, such as trouble smiling, chewing, speaking or closing the eyes
- Blurred or double vision, or difficulty moving the eyes
- Difficulty breathing, in more serious cases
- Trouble swallowing or speaking clearly
- Severe pain, especially in the back, legs, or shoulders, often worse at night
- Changes in heart rate or blood pressure, such as rapid heartbeat or dizziness
- Loss of bladder or bowel control (in some cases)
- Difficulty speaking or swallowing (dysphagia)
- Difficulty breathing, especially if chest muscles are affected
One of the most serious aspects of GBS is how quickly symptoms can progress. Most people reach their worst level of weakness within two to three weeks after symptoms begin. In severe cases, GBS can cause temporary paralysis, requiring mechanical ventilation to support breathing.
Guillain-Barre Syndrome can worsen so quickly that early detection is critical. If you or someone you know develops sudden weakness, numbness, or difficulty walking, especially after a recent illness or infection, it’s important to seek medical care right away.
Guillain-Barre Syndrome Symptoms in Children
In children, Guillain-Barre Syndrome (GBS) can be hard to spot at first. Many kids can’t explain what they’re feeling, so it’s important to watch for changes in how they move or act.
Here are some signs to look for:
- Refusing to walk or stand, even if they were walking fine before
- Crying or acting upset when you try to move their legs
- Sudden leg pain, especially in the thighs or calves
- Frequent falls or seeming more clumsy than usual
- Struggling to climb stairs or get up from the floor
- Weakness in the face, like a drooping smile or trouble closing their eyes
- Difficulty chewing, swallowing, or speaking clearly
- Unusual tiredness or needing more naps than normal
- Breathing problems (in more serious cases)
- Dizziness or fainting, which could mean blood pressure changes
- Balance problems or walking with a wide, unsteady gait
These symptoms can come on suddenly or slowly over a few days. If your child recently had a cold, stomach bug, or another illness and starts showing any of these signs, contact your doctor right away.
What are the Different Types of Guillain-Barre Syndrome?
Guillain-Barre Syndrome (GBS) has several different forms, each with slightly different symptoms and severity. The type of GBS a person develops depends on which part of the peripheral nervous system is affected and how the immune system attacks the nerves. Understanding the different types of Guillain-Barre Syndrome helps doctors make accurate diagnoses and guide treatment.
Here are the main types of GBS:
Acute Inflammatory Demyelinating Polyneuropathy (AIDP)
- This type is most common form in the U.S. and Europe
- Causes damage to the myelin sheath, the protective covering around the nerves
- Typically begins with muscle weakness that starts in the legs and spreads upward
- Other symptoms may include slow reflexes, facial drooping, and difficulty swallowing
- In some cases, AIDP can lead to breathing issues or heart rhythm problems
- Usually worsens over a few weeks, then gradually improves with treatment
- If symptoms persist beyond 8 weeks, it may progress into CIDP (Chronic Inflammatory Demyelinating Polyneuropathy)
Miller Fisher Syndrome (MFS)
- A rare variant of GBS, more common in Asia
- Affects the cranial nerves, especially those that control eye movement
- Common signs include double vision, poor coordination, and unsteady walking
- May also involve facial weakness, trouble swallowing, or mild limb weakness
- Most people recover fully, often within a few months
Acute Motor Axonal Neuropathy (AMAN)
- Affects the motor nerves’ axons, without sensory loss
- Common in children and young adults, particularly in China, Japan, and Mexico
- Causes severe muscle weakness, often requiring respiratory support in serious cases
- Recovery can take weeks to months, depending on severity
Acute Motor-Sensory Axonal Neuropathy (AMSAN)
- A more severe form than AMAN, affecting both motor and sensory nerves
- Leads to numbness, tingling, and rapid weakness in all limbs
- May result in loss of reflexes, difficulty walking, and breathing problems
- Recovery is often slower and more challenging
Acute Panautonomic Neuropathy
- A very rare type of GBS that affects the autonomic nervous system, which controls involuntary body functions
- Symptoms may include low blood pressure, irregular heartbeat, digestive issues, sweating problems, and bladder/bowel dysfunction.
- It often requires intensive care and has a slower, less complete recovery
Pharyngeal-Cervical-Brachial Variant
- A rare subtype where weakness is limited to the face, throat (pharynx), neck (cervical), and arms (brachial)
- Does not usually affect the legs
- Can cause difficulty speaking, swallowing, and lifting the arms
- Breathing is usually not affected unless symptoms progress
Pure Sensory GBS
- Involves only the sensory nerves, not motor nerves
- Causes severe numbness, tingling, and balance issues (sensory ataxia)
- Muscle strength may remain normal, but reflexes are often absent
- Very rare and can be difficult to diagnose without nerve testing
While Acute Inflammatory Demyelinating Polyneuropathy (AIDP) is the most common type of GBS, especially in Western countries, other forms like AMAN, AMSAN, and Miller Fisher Syndrome are seen more frequently in specific regions or age groups. The symptoms, severity, and recovery time can vary greatly depending on the type, which is why accurate diagnosis and early treatment are so important.
Guillain-Barre Syndrome Causes
The exact cause of Guillain-Barre Syndrome (GBS) is still not fully understood, but it often occurs after an infection. GBS is considered a post-infectious, immune-mediated condition, which means it usually develops after the immune system responds to an illness and mistakenly begins attacking the body's own nerves.
Normally, the immune system defends the body against viruses and bacteria. But in GBS, this defense system becomes overactive and targets the peripheral nerves, damaging their outer covering (called the myelin sheath) or the nerve fibers themselves. This damage disrupts signals between the brain and the body, leading to weakness, numbness, or even paralysis.
In many cases, symptoms appear within 1 to 6 weeks after a prior infection or health event. Some known Guillain-Barre Syndrome causes and triggers include:
Infections (most common)
- Campylobacter jejuni, a bacteria often found in undercooked poultry, is the most common known trigger.
- Influenza (flu virus)
- Cytomegalovirus (CMV)
- Epstein-Barr virus (EBV)
- Zika virus
- Hepatitis A, B, C, or E
- HIV
- COVID-19 virus
Vaccinations (rare)
- In very rare cases, GBS may occur after certain vaccines, such as the flu shot or childhood immunizations
- However, research shows that the risk of getting GBS from an actual infection is higher than from a vaccine.
Other Triggers
- Recent surgery
- Physical trauma
- Certain types of cancer, like Hodgkin lymphoma
While the exact reason why GBS develops in some people and not others is still being studied, infections are the most common trigger. The immune system’s abnormal response plays a key role in damaging the nerves. If you’ve recently been ill and start to feel tingling, weakness, or difficulty walking, it’s important to seek medical attention quickly.
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Get Second OpinionRisk Factors for Guillain-Barre Syndrome
Guillain-Barre Syndrome (GBS) happens when the immune system mistakenly attacks the nerves. While the exact cause is not always clear, several factors can increase the chance of developing GBS. Understanding these risk factors can help doctors identify and manage the condition better.
Common Risk Factors
- Age: People over 50 are more likely to get GBS. As we age, the immune system can change and sometimes overreact, leading to nerve damage.
- Gender: Men have a slightly higher risk of GBS than women. This might be due to differences in hormones or genetics.
- Recent Infections: Many people develop GBS after an infection. Common triggers include bacterial infections like Campylobacter (from undercooked poultry) and viral infections like the flu or Zika virus. These infections can cause the immune system to mistakenly attack nerves.
- Chronic Illnesses: Diseases that affect the immune system, such as lupus or HIV, can increase the risk of GBS because they cause ongoing inflammation or weaken the immune defenses.
- Surgery or Injury: Stress on the body from recent surgery or injuries may trigger an abnormal immune response that harms nerves.
- Vaccinations: Though very rare, some vaccines like flu shots or certain COVID-19 vaccines have been linked to a slightly increased risk of GBS. However, vaccines are generally safe and their benefits outweigh the risks.
- Other Factors: Some medical conditions like Hodgkin’s lymphoma and infections such as Mycoplasma pneumoniae or hepatitis viruses may also increase the risk of GBS.
While these factors may increase the risk, it’s important to remember that Guillain-Barre Syndrome remains rare, and many people with these risk factors never develop the condition. If you have concerns, discuss them with your healthcare provider.
How Is Guillain-Barre Syndrome Diagnosed?
Diagnosing Guillain-Barre Syndrome (GBS) can be tricky, especially in the early stages, because its symptoms often resemble other neurological conditions. That’s why healthcare providers use a combination of tools to confirm the diagnosis.
Here’s what the process usually involves:
Medical History and Physical Exam
Your doctor will start by asking about recent illnesses, vaccinations, or infections. They’ll check for key symptoms like muscle weakness, loss of reflexes, or unusual sensations.
Spinal Tap (Lumbar Puncture)
This test collects cerebrospinal fluid from your lower back. In most people with GBS, the fluid shows high protein levels with a normal white blood cell count, a common sign of the condition.
Nerve Tests
Two types of electrical tests are used to check how well your nerves and muscles are working:
- Electromyography (EMG): Small needles are inserted into muscles to measure their electrical activity.
- Nerve Conduction Studies: Small electrodes are placed on the skin to test how fast electrical signals move through your nerves.
Imaging (MRI)
An MRI scan of the spine may be done to rule out other issues like nerve inflammation, disc problems, or spinal cord conditions.
What are the Guillain-Barre Syndrome Treatment Options?
Guillain-Barre Syndrome (GBS) is a serious but treatable condition. While there’s no cure yet, early treatment can significantly improve your recovery, reduce the severity of symptoms, and help prevent life-threatening complications. Most people with GBS will need to be treated in a hospital, often in the Intensive Care Unit (ICU), especially if breathing or heart functions are affected.
Primary Treatments
Two main treatments are used to stop the immune system from attacking the nerves:
Plasma Exchange (Plasmapheresis)
Plasmapheresis is a procedure that removes harmful antibodies from your blood, the ones that are mistakenly attacking your nervous system.
How it works:
- Blood is taken from your body and passed through a machine.
- The machine separates and removes the plasma (the liquid part of the blood that contains the antibodies).
- The remaining blood cells are returned to your body along with new plasma or a plasma substitute.
What it does:
- Reduces the level of destructive immune proteins.
- Can slow down or stop nerve damage.
This treatment is usually started within the first few days of symptoms for best results.
Intravenous Immunoglobulin Therapy (IVIG)
IVIG is a treatment that involves giving high doses of healthy antibodies through a vein (IV drip).
How it works:
- The immunoglobulin comes from thousands of healthy donors.
- These antibodies help block the immune attack on your nerves.
Benefits of IVIG:
- Just as effective as plasmapheresis.
- Often more convenient, especially for children or people with unstable health.
Important note:
Both plasmapheresis and IVIG are effective,
but combining them doesn’t offer any extra benefit. Doctors will choose the most suitable
option based on your condition and other health factors.
Managing Complications
Guillain-Barre can lead to complications that affect your breathing, blood pressure, and muscle control. Doctors and nurses will monitor you closely for:
- Breathing problems: You may need a ventilator if the chest muscles become weak.
- Irregular heartbeat or blood pressure issues: Common due to nerve involvement.
- Blood clots: You may be given blood thinners to prevent clot formation from lying in bed too long.
- Swallowing problems: If you can’t eat or drink safely, IV fluids or a feeding tube may be used to avoid dehydration or malnutrition.
Rehabilitation and Recovery Support
Recovery from GBS can take weeks to months, and full rehabilitation support is often needed.
- Physical Therapy: Helps rebuild strength, flexibility, and movement. Therapists guide you through exercises that gradually improve muscle control.
- Occupational Therapy: Focuses on relearning everyday tasks like bathing, dressing, writing, and using utensils. It helps restore independence.
- Speech and Swallowing Therapy: If GBS affects the muscles used for speaking or swallowing, therapy can help you regain these functions safely.
- Mobility Aids: Devices like braces, walkers, canes, or wheelchairs may be needed temporarily or long-term. These tools can reduce fatigue and prevent falls while your body heals.
When to See a Doctor?
If you notice tingling, weakness, or numbness that worsens or spreads over a few days, don't ignore it. Guillain-Barre Syndrome can progress quickly, and early treatment is key to recovery.
You should see a doctor immediately if you notice:
- Weakness or tingling that begins in your feet or hands and quickly spreads to other parts of your body
- Difficulty walking, climbing stairs, or using your arms
- Trouble breathing, swallowing, or speaking clearly
- Rapid changes in your heartbeat or blood pressure
- Loss of reflexes or muscle control
Early medical care is very important for managing GBS and preventing complications. If symptoms appear suddenly or worsen quickly, seek emergency care right away.
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What Precautions Can Help Prevent Guillain-Barre Syndrome?
Guillain-Barre Syndrome (GBS) is hard to predict and can’t always be prevented. It often happens after an infection, but not everyone who gets sick will get GBS. Still, you can take some simple steps to lower your chances of getting infections that might trigger GBS.
Prevention Tips
- Wash your hands often: Use soap and water, especially before eating and after using the bathroom.
- Avoid undercooked poultry: Make sure chicken and other meats are fully cooked to kill harmful bacteria.
- Clean frequently touched surfaces: Wipe down things like doorknobs, phones, and countertops regularly.
- Keep up with your vaccines: Vaccines help protect against infections that could lead to GBS.
- Stay away from sick people: Avoid close contact with anyone who has the flu, stomach bugs, or other infections.
- Stay healthy overall: Eat well, exercise, get enough sleep, and manage stress to keep your immune system strong.
Even if you take all these precautions, GBS can still happen. But these steps help protect your health and reduce your risk of infections that might trigger it.
What are the Complications of Guillain-Barre Syndrome?
Guillain-Barre Syndrome (GBS) can lead to a variety of complications, especially if symptoms progress rapidly or affect the autonomic nervous system, which controls essential functions such as breathing, heart rate, and digestion. While many people recover fully, others may experience lasting or serious health issues during and after the illness.
Breathing Problems
If GBS weakens the muscles that help you breathe, it can become difficult to breathe on your own. Some people may need help from a ventilator (breathing machine), especially in the first week of illness.
Irregular Heartbeat and Blood Pressure Changes
GBS can disrupt the autonomic nervous system, leading to:
- Irregular heartbeat (arrhythmias)
- Extremely high or low blood pressure
- Risk of sudden cardiac attacks
This condition is known as dysautonomia, and it requires close monitoring in a hospital setting.
Ongoing Numbness or Weakness
Even after treatment, some people have lingering nerve damage, which may cause:
- Tingling or numbness
- Muscle weakness
- Trouble walking or using their hands
Blood Clots
Being inactive for a long time can increase the risk of blood clots in the legs (deep vein thrombosis). Doctors may give blood thinners or use compression socks to prevent this.
Bedsores (Pressure Ulcers)
People who are unable to move much may develop painful sores from lying in bed too long. Regular position changes and good skin care can help prevent this.
Bladder and Bowel Issues
Nerve damage may affect the ability to go to the bathroom normally, causing:
- Difficulty urinating
- Constipation or slow digestion
Nerve Pain
Many people with GBS experience burning, shooting, or aching pain due to nerve irritation. This pain can continue during recovery, but can be managed with medication.
Joint Stiffness and Muscle Tightening
Lack of movement can cause joints to stiffen or muscles to shorten (called contractures), which may affect posture or mobility. Physical therapy helps prevent this.
Swallowing Problems & Pneumonia
If throat muscles are affected, swallowing can become difficult, increasing the risk of choking or pneumonia from food or liquid going into the lungs.
Relapse (Rare)
In rare cases, GBS can return even after recovery. This is known as a relapse and may need treatment again.
Most people with GBS recover well, especially with early treatment and proper care. Regular monitoring, physical therapy, and support can help reduce the risk of complications and support a full recovery.
Our Experience Treating Guillain-Barre Syndrome
At Medicover, we understand how frightening Guillain-Barre Syndrome can be. Our experienced team uses advanced tests to diagnose GBS quickly, allowing us to start treatment as soon as possible.
Our care includes:
- Close monitoring of your nerve and muscle function, as well as your breathing and heart health
- Treatments like plasma exchange (plasmapheresis) or intravenous immunoglobulin (IVIG) to stop the immune system from attacking nerves
- Supportive care, such as physical therapy and rehabilitation, can help you regain strength and movement
- Emotional support and guidance to help you and your family through recovery
- Regular follow-ups to watch your progress and manage any lasting effects
Our goal is to provide you with expert, compassionate care, helping you recover and regain your independence as fully and quickly as possible.
